Neurological diagnostic instrument



Oct. 13, 1959 M. c. GUEST NEUROLOGICAL DIAGNOSTIC INSTRUMENT Filed Sept. 2l, 1956 United States Patent @nice Patented Oct. 13, 1959 NEURLOGICAL DIAGNOSTIC INSTRUMENT Maurice C. Guest, Coral Gables, Fla.

Application September 21, 1956, Serial No. 611,212

2 Claims. (Cl. 12S-2) This invention relates to certain new and highly useful improvements in a diagnostic instrument used primarily for the neurological phases of a complete physical check-up on a patient.

Construed in terms of generalities and, patentably speaking, the concept has to do with an improved neurological percussion hammer which is novel in that it is of sectional construction and hence knockdown for ease of cleaning and repairing and embodies mutually co operating components which enhance the over-all utility of the hammer as an entity.

It is a matter of common knowledge and the lamer of many diagnosticians that errors in a complete examination of a patient for admission to a hospital are traceable to the fact that an examination may be carried out in the patients home or perhaps at a hospital where required instruments `and tools are not available. It follows that if the physician does not have the required instruments with him, the resultant examination is incomplete in proportion to the stages of the examination which were not carried out. There has long existed, therefore, a recognized need for a single instrumentality which, being a compact and convenient entity, places at the physicians disposal the means needed. It follows that a signiicant objective in the instant matter is to provide a single structural device which, as afore-stated, is essentially a percussion hammer, but includes within its over-all construction selectively usable components, for example, a hammer having a so-called scratching element which is complemental to the hammer in eliciting reiiexes.

Then, too, novelty is predicated on the stated precussion hammer utilizing a handle, that is, a handle of a composite character which provides a hand grip affording the necessary handling and leverage properties, and a structurally unique shank structure alfording a connection between the hammer head and the hand grip and which is such in construction that it also functions as a tuning fork.

Stated otherwise, the handle in 'an over-all sense is extensible and contractible and the components thereof are separable. In fact, the hand grip is so constructed that it constitutes a sheath-like case for the prongs of the tuning fork and also has a holder in which a conveniently usable measuring tape is stored for expedient use.

Other objects, features and advantages will become more readily apparent from the following description and the accompanying sheet of illustrative, but not restrictive, drawings.

In the drawings, wherein like numerals are employed to designate like parts throughout the views:

Fig. 1 is a perspective View of a neurological diagnostic instrument, primarily a percussion hammer, constructed in accordance with the principles of the invention;

Fig. 2 is an enlarged View of the invention and partly in elevation taken on the plane of the line 2 2 of Fig. l looking in the direction of the arrow;

Figs. 3 and 4 are cross sections on the lines 3 3 and 4-4, respectively, of Fig. 2;

Fig. 5 is an exaggerated perspective View of an exploded type showing certain of the structural details; and

Fig. 6 is a perspective view of a modied form of hand grip.

Referring now to the drawings and particularly to Figs. l to 5, inclusive, it will be lseen that the handle is sectional, knockdown and extensible and contractible. It embodies the aforementioned hand grip, and this is denoted by .the numeral 8. It is preferably constructed from moldable plastics. It is elongate and rectangular in Cross section, as seen in Fig. 3, and has an enlarged head portion 10 atone end and a body portion 12. 'Ihe body portion is recessed. That is to say, it is recessed in such a way that it provides spaced parallel bores 14 and 16. At the left in Fig. 2 the bores are shown open and the opposite ends are closed. Mounted in each bore is a longitudinally bowed leaf spring 1S secured in place at 20. The central portion of the body may be provided with extra bores or sockets 22 and 24, which may be used for readily insertable and removable accessories often used during the course of a neurological examination. These are not to be dwelled upon here. In the enlarged head portion there is a recess 26 which provides a pocket and which has a slot 28 along its margin and openable and closable flaps 3ft, and this provides a pocket for storage of an insertabie and removable measuring tape 32.

The shank structure or means is of a composite type. The major portion thereof is denoted at 34 and, specir'ically, this takes the form of a tuning fork, the prongs 36 of which are fitted in the socket-like bores 16 and held frictionally lagainst displacement by way of the springs 18. At the left hand end there is an axial extension 38 which may be used as the handle of the tuning fork when used by itself, and this is provided with a depression 40 providing a keeper seat. rl`his serves to accommodate a detent 42 forming a part of a socket member 44 which is tted in a sleeve-like manner over the shank portion 38. The shank is therefore made of the pronged body portion 34 adjustably and removably mounted in the sheath-like hand grip 8, the extension 38 and the socket member 44. The outer end of the socket member is provided with a pair of spaced, parallel terminal members 46 which serve to support the triangular rubber impact or hammer head 48. This is secured in place between the members 46, as at 50 It will be noted that the rearward end of the socket member is formed with diametrically opposite slits 52, providing springy grips 54 which, as shown in Fig. 4, serve to frictionally grip the shank extension 38. Also, and as brought out in Fig. 5, a pointed scratching element 56 is provided and constitutes one of the rellex elements of the hammer head means.

With a View toward acquainting the reader with the significance and purposes of the components which go to make up the composite hammer structure, brief coverage'of the functions of the components is thought to be in order, to wit:

The prime use would be as a percussion hammer and as the complete tool stands that is what it is. This is also probably the most commonly carried tool of the combination. The rubber hammer head is used to elicit deep reflexes. It is used to hit just above the patella onthe knee to make the knee jump. As a result, it is possible to tell whether there is an unbroken nerve circuit or pathway to carry the sensation of the blow on the knee to the spinal cord and then return a nerve impulse to move the muscles and make the knee jerk.

The pointed projection on the shank structure or means,`

is merely va convenient-element--for scratching tov elicit reflexes, such as the Babinski reex, from the bottom of the foot. When a normal persons foot is so scratched, the toes will move-downwardly. Howeven when-'thesame 1s done to babies under fourmonths `or'to'peoplezvvho have defects in the lateralpart -oftheir spinal cord,-such scratching--willcause the-toes toliair and go aupward. Quite -often--a doctonmayebreak atonguefblade orruse a key to do this, and those things work, but it ,wouldjbe handier' to -always Ahave the instant means readilyavailable for-use.

A tuningforkisused -for Aseveral diierent tests. "Two commonly used-tests-for4 hearing make -use offit. V`'One test -places thevibratingforkat'the -vertex of-thehead Theability to hear` t-heY vibrationsdifferently: in the opposite ears is-a1funetion-ofthe test. 'Anothertest usesthe vibrating lfork-to-tell thediierence between-deafness due to diseaseof the acoustic nerve and to-deafness due to occlusionorsomethingWrong-with'the ear-itself. In this (test thevibrating forkis alternatelyA heldin -front ofl the ear and on-the mastoidbone behindthe ear. :Thepurpose -of the'testis tond vout which eanbe heard '-best, the vibration'coming-throughthe air or thattransrnitted through the'bone.

In addition,-the fork-is used-toreveal-nerve damage which is associated-with inability to feel vibrations. With the-fork vibrating, it is placed against-a-boneyprominence on the=lower extremity. A normal-person can-feel-this, but a person aiieted `with pernicious anemia and the accompanying nerve v disease cannot feel this. Occasionally,this'istherstsyrnptomeof such fadisorderso, it is important to make thistest.

For measuring circumferences ofchest, abdomen, yextremities,etc.,a tape measureis very-essential-and such measurements are'quite often required Usually, however, whenlone is most'needed, it isnt available. This inventionfprovides a convenient space for-sueha tape, either as a loose'tapewound and-inserted-in-thehandle or in case With-spring yfor retracting the tape into its separate little case as is shown -in Ithe patent drawings. In addition, the enlarged-or bulbous endof-'thefhandle is of such a shape as to fit the palm of -thethand While I have stated that this invention functions primarilyfor neurological examinations,=thesimple tests I have` mentioned *in conjunction ,with the contributing' components of the samerare those used Iby #every first and second year medical student and-recommendedfor use in any complete examination 'recorded on a-fpatient for admission -to a hospital. fOf-course, in -practice'many of theseexaminationstepsarenever donebya physician 4once he leaves the 4place of Ihis training, 1`butthatiislnot because he -shouldnt, but just -because jof thefact that no one enforces the `training he'has lbeenftaught. It is `the-common lamentfof mostdiagnosticians thatgenerally errors -ina diagnosis are not made because .of =ignorance, `but because an adequate examination -was notdone. 4It

`is my ybelief that this instrumentality will, Lbyihaving the tools readily available in theone,.easilycarriedombina- `tiondo much to get both students and graduate physicians lto doa Vmore completeexamination. One of .the'main reasons Why the examination is not as complete las .it should .be is that 'it may be done Ain a home, =or in a hospital where there just arent any such ytools available. Such toolsare not generally .furnished by the hospital and if the doctor doesnt have them with him, he doesnt do what should be done. It follows that the 4need for this inventionin lits .entity is outstandingly important.

The inherent correlation and cooperation of the cornponents which go to make up the over-all percussion hammer obviously make for the mutual contribution thereof and promote the new and improved results desired.

With reference now to the modiication seen in Fig. 6, the basic construction is the same as that already described. That is to say,'the'hand grip 8A will be constructed much the same as that already covered, except that instead'of `having Va socket for the'prongs of the tuning fork embodiedin the body portion .12, the body 12A here has lengthwise keying grooves 60 formed therein. The holes 22A and'24Arare as already described. So is the recessed, knob-likefenlargement 10A. In other words, the only difference is in substituting the groove 60 for the bores 14- and 16. Obviously, these grooves serve to permit the prongs 64 to be keyed removably therein in an evident manner.

The foregoing is-considered lasillustrativeonly of the principles of the invention. lFurther, since numerous modifications and changes will readily occur to Athose vskilled in the art, it is not desired to limit theinvention tothe'exact-construction and operation shown and described, and accordingly all suitable modifications and equivalents may be resorted to, -falling in/the scope of thelinvention as claimed.

-Whatlis claimed as newis as follows:

1.1For use by'a neurologist, a self-contained readyto-use diagnostic instrument adapted for use in conducting a physical or neurological examination comprising, in combination, an extensible and ycontractiblehandle embodying a-handgrip, a shank yslidingly and-removably mounted on said hand grip and-having an axial. extension at an outwardly disposed yend, and reiiex means, including `a percussion hammencarried'by said axial extension and servingto elicit deep reflexes, said handgrip being recessed and the inward end portion-of said shank havingspaced parallel prongs removably-butretentively fitting-into -recesses provided therefor in saidihand-grip one recessed portion of said hand-grip constituting a pocket in .which a measuring tape maybefremovably stored for procedural use.

2. For use by a physician, a neurologist-forl example, a self-contained ready-to-use diagnostic instrument adapted foruse in conducting a physical or neurological .examination comprising, in combination, anfextensible and l.contractible? handle embodying ahand grip, ashank slidingly and removably mounted on said hand'gripfand-having an axial extension at its outwardly disposed end, vand reex means, including a percussion hammer, -carried by-said axial extension 'and serving to elicit deep reexes, said hammer embodying a vsocket member Aand head, said extension constituting a shank, the latterttingtelescopically and removably in said socket member, said socket member having a detentand said axial extension'having a keeper seat in which the detent is removably seated and latched in place while in use.

References lCited in the tile of this patent UNITED STATES :PATENTS 273,621 Small Mar. 6, 1883 1,267,554 Karatsu May 28, 1918 1,269,820 Karatsu June 18, 1918 2,315,160 Newstedt Mar. 30, 1943 2,609,019 Weber Sept. 2, 1952 

